AccountId: 011433970860
ContactId: 12fd1622-043b-45f2-b0c8-0beb46239ba2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 344980 ms
Total Talk Time (AGENT): 108865 ms
Total Talk Time (CUSTOMER): 148202 ms
Interruptions: 2
Overall Sentiment: AGENT=0, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/16/12fd1622-043b-45f2-b0c8-0beb46239ba2_20250416T12:47_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey, good morning. Uh, my name is [PII] and I'm calling you from the provider office to check the claim status.
[AGENT][NEUTRAL] OK, what's the policy number, [PII]?
[CUSTOMER][NEUTRAL] Uh, yeah, just a moment. Here we go.
[CUSTOMER][NEUTRAL] OK, here we go, that is the um.
[CUSTOMER][NEUTRAL] Uh C as in Charlie, 0596560007.
[AGENT][NEUTRAL] OK, that's not an APL policy number. Do you have a copy of the card that you can look at?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Just a moment.
[CUSTOMER][NEUTRAL] OK, here we go, that is the.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Uh, yes, it's, it's, it is same like C Charlie 056560007.
[AGENT][NEUTRAL] What's the name of the insurance company on the card?
[CUSTOMER][NEUTRAL] Uh, I choose APL, American Public Life.
[AGENT][NEUTRAL] OK, I couldn't say American Public Life. Um, our policy number doesn't start with a C.
[AGENT][NEUTRAL] So that's the name that's on the card?
[CUSTOMER][NEUTRAL] C as in Charlie, right?
[CUSTOMER][NEUTRAL] Mm, yeah, because I have seen just I have opened that, uh, um, um, insurance card and uh I have uh seen that the member.
[AGENT][NEUTRAL] Read, read the information on the card. Can you read the information that's on that card?
[CUSTOMER][NEUTRAL] Uh, yes, sure. It, it, it says, uh, insured name, coverage, group number, effective date, and then plan name, uh, meddling select group medical, uh.
[CUSTOMER][NEUTRAL] Inpatient, outpatient, and then American public.
[AGENT][NEUTRAL] What's the group number?
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] What's the group number?
[CUSTOMER][NEUTRAL] Group number is 22811.
[AGENT][NEUTRAL] Give me that one more time.
[CUSTOMER][NEUTRAL] 22811.
[AGENT][NEUTRAL] 22811. Is there a group name on the card?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Group number, yes. It's a group number.
[AGENT][NEUTRAL] I know it, but it does it list the group name as well?
[CUSTOMER][NEUTRAL] Uh, uh, actually, uh, the group number is not showing. Plan number is there. It's Med link select group Med.
[AGENT][NEUTRAL] Right, but I can search for the policy number under the group number. You said it's 22811?
[CUSTOMER][NEUTRAL] Right. That was the group number.
[AGENT][NEUTRAL] Spell the patient's last name?
[CUSTOMER][NEUTRAL] I just um.
[CUSTOMER][NEUTRAL] G girl, A alpha, R Romeo, R Romeo, I India, G, A, Alpha, and Nancy.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, and the spelling of the first name, please?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] And what state does [PII] reside?
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] Where does he live? What state?
[CUSTOMER][NEUTRAL] Uh, it's [PII].
[AGENT][NEUTRAL] OK. You have a date of birth for the patient?
[CUSTOMER][NEUTRAL] Date of birth, yes, I have. It's uh [PII].
[AGENT][POSITIVE] Thank you for that.
[AGENT][NEUTRAL] The policy number is 174.
[AGENT][NEUTRAL] 0525.
[AGENT][NEUTRAL] And you said that you're checking a claim status, can you verify the date of service and the total charge?
[CUSTOMER][NEUTRAL] I'm just looking for the status whether the insurance is active or not for [PII].
[AGENT][NEUTRAL] So are you you're calling to verify eligibility or claim status?
[CUSTOMER][NEUTRAL] Uh, claim status for
[CUSTOMER][NEUTRAL] Uh, no. [PII].
[AGENT][NEUTRAL] OK. [PII], is that the date of service?
[CUSTOMER][NEUTRAL] Yes, right.
[AGENT][NEUTRAL] And what was the [PII] date of service?
[CUSTOMER][NEUTRAL] Uh, that is for the current one. That is for the current claim which we have, which we
[AGENT][NEGATIVE] That's incorrect. OK.
[AGENT][NEUTRAL] So the correct date of service is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] And the total charge?
[CUSTOMER][NEUTRAL] Uh, it was $200 even.
[AGENT][NEUTRAL] 200
[AGENT][NEUTRAL] OK, I'm not showing that date of service on file for [PII].
[CUSTOMER][NEUTRAL] Dollars even.
[AGENT][NEUTRAL] Um, I'm showing this policy became effective [PII], and the policy is no longer active as of [PII].
[CUSTOMER][NEUTRAL] For
[CUSTOMER][NEUTRAL] OK. So who is the primary insurance? Can you please let me know right now?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Who is the primary insurance for this claim for right now? Currently, who is, who is showing as primary insurance?
[AGENT][NEUTRAL] Let me verify if we have that information and you can also check with your patient as well.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Our records indicate UHC.
[CUSTOMER][NEUTRAL] UC is showing primary insurance for the member, is it?
[AGENT][NEUTRAL] That's what we show, but you also wanna check with your, your patient as well.
[CUSTOMER][NEUTRAL] OK. May I have the member ID for UHC?
[AGENT][NEUTRAL] I don't we don't have their information, sir. You'll have to call their company.
[CUSTOMER][POSITIVE] OK, thank you so much.